Editorial

Welcome to the first homepage edition of i2P for 2012.In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011. One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board. We apologise to all those potential subscribers who were unable to register with us in the second half of 2011, but if you try once more you should have no problem.

Pipeline

Pipeline for February 2012

A range of global and local news snippets and links that may be of interest to readers.Pipeline Extras simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.

Feature Contribution

Pharmacist prescribing is GO! …. Not so the funding

Pharmacist prescribing has been on the radar for some years in New Zealand, and we finally have sufficient traction so that the Postgraduate Certificate for prescribing is starting to 2012. The prerequisites to undertake the 600 hour (two semester) course are:

Pharma-Goss - HMR/MMR – an opportunity to be gained

This writer is impressed by the HMR/MMR process and was never more surprised than finding out the rigorous nature of the accreditation process that needs to be undertaken for a pharmacist to become eligible to undertake the tasks, report and claim the $196 through Medicare.The immediate reaction is “what are we trying to produce – an academic genius that could mix it with the best of pharmacologists” rather than a pharmacist able to look at a medicine taking situation - assess its quality and make recommendations to a doctor on where changes might benefit the patient.

Friends of Science in Medicine

A powerful group (The Friends of Science in Medicine (FSM)) comprised of medical academics and interested professionals has sprung into existence under the guidance of CEO Loretta Marron (Australian Skeptic of the Year 2011), Professor Alastair MacLennan, Emeritus Professor John Dwyer, Professor Rob Morrison and Professor Marcello Costa and a cast of 400 Australian and international names.Their full title, academic establishment and contact details are included in the press release that follows, along with a link containing the full list of academics involved.The aim of this group is to directly challenge those universities that provide education and degrees to support some health disciplines, not deemed to be evidence-based.This is in effect, a full-frontal confrontation to the universities that appear on the "naughty list (and there are quite a number).It will also be confrontational to government and the agencies involved with regulating and monitoring the various health disciplines.

It’s Time!

Yes folks, the time is here. Either we re-focus on our usefulness within the health care team, or we continue to be peripheral watchers from the outside, wondering why other professions get all the kudo! Why is a particular professional group involved in these discussions on health, and why is another given a vital role to play in this disease and their members get a provider number to claim their professional service fees?

Confessions of a Frustrated Pharmacist

I know the editor has selected me for this particular job because he knows how passionate I am about patient outcomes. He wants me to promote an ethical view of a pharmacsit's involvement with nutritional medicine.He also knows that I am totally opposed to any form of medical fraud.I have not approached any Australian pharmacists to brief me on their personal experiences because I do not want their reputations to be damaged in any way.So I have co-opted the resources of the Orthomolecular News Service to initially help out as they have a talented pool of health professionals from a number of disciplines that just happen to believe (as I do) that nutritional medicine can help many patients achieve a better outcome than they can through orthodox medicine alone. And there is plenty of evidence to support this view.

Are the discounters impacting community pharmacy beyond margin erosion?

I’m not sure about this, just as I’m not sure if Chemist Warehouse is Australia’s cheapest pharmacy. However, I have been asked that question in the printed media hundreds of times along with every other literate Australian. What I’m wondering is if there is a direct causal relationship between the rise of the pharmacy group, Chemist Warehouse being the largest of these, and the reduction in support to all those independent pharmacies that are still trying to operate either individually or in much smaller groups. My thinking goes like this.

$75.5 million in 5CPA lying idle. Why is it so?

When I read the Guild’s Submission to the Senate Inquiry into the provisions of the Personally Controlled Electronic Health Records Bill 2011 and (Consequential Amendments) Bill I called upon the services of my trusty friend ‘Frank’ to sit with me and contemplate what the Guild meant when it wrote that it felt it “pertinent to raise some issues that will be key to the success of the PCEHR and e-health in general for Australia”.

The Guild said:“The Guild is concerned that money that has been set aside within the 5th Community Pharmacy Agreement ($75.5 million) for the uptake of electronic prescriptions is currently lying mostly unused”

Natural Medicines - the good, the bad and the ugly

I am often asked if I am 'for or against' complementary medicines (CMs) . My one-liner response is to say "it depends on the evidence".So why do I find this question so difficult to answer?CMs can be categorised into narrative-based medicine, evidence-based medicine or snake-oil.Throughout history, and across all cultures, narrative-based medicines(NBMs) were carefully prepared by traditional healers from recipes passed down through the generations. Made from concoctions of combinations of local flora and fauna and the occasional mineral, they were used to treat a wide range of health complaints.

The War Against Nutritional Medicine Why We Love Our Critics

Andrew Saul is the US editor of Orthomolecular Medicine Newsletter, which is a newsletter devoted to circulating news and research about clinical nutrition.The editorial review board is global in scope and includes two Australians -Ian Brighthope, M.D and Michael Ellis, M.D. as well as a range of pharmacists from various parts of the world.i2P is dedicated to allowing many opposing points of view to be debated within the pages of its publication believing that if sufficient information is available for all sides of a debate then pharmacists are able to make informed independent decisions on the type of education and advice they can give to their patients.Clinical nutrition is one of the health sciences that sometimes has criticism applied from orthodox medical quarters, often mindlessly, because they have not been trained and prefer to remain ignorant rather than accept a direction from a trained clinical nutritionist (and there are quite a few Australian pharmacists trained up here).

Onside with Online

On-line communications and statistics should be, and are, the friends of those in business. However, one needs to look behind the statistics for understanding, value and worth.For many, the staple diet of statistics in the mass media about the growing presence and influence of on-line channels of communication and supply is both intimidating and overwhelming. Equally, those data can be misleading or incomplete, not revealing the full story.

I’ve been thinking…The Rest of the [Thankful for An MRI?] Story

I’ve been thinking about a village, a tribe, and A League of Their Own. The MRI, if not the nightly pain, prompted me to sign up for the rotator-cuff repair, a 70- minute procedure that was successfully completed on Tuesday afternoon (12/13). It was difficult to keep count, but before I went completely under, I recall being touched by nearly a dozen caregivers (e.g., nurses, technicians, anesthesiologists, and surgeons), to say nothing of the behind-the-scenes cast from pharmacy, housekeeping, engineering, admitting, administration, billing, parking, and security. Hospitals are villages.

Support services for pharmacists and doctors in the United Kingdom – Part 3 Royal Medical Benevolent Fund

In Australia the Pharmacists’ Support Service (PSS) provides a listening ear and support over the telephone to pharmacists in Victoria, Tasmania, South Australia and the Northern Territory and has plans for expansion to all states of Australia. The medical profession in Australia has a range of state based Doctors’ Health Advisory Services including the AMA Victoria Peer Support Service which provides peer support over the telephone. Victorian is the only state to have a state based health program for doctors; the Victorian Doctors Health Program (VDHP). Funding from the Cyril Tonkin Fellowship enabled me to undertake a study tour of services which support pharmacists and doctors in the United Kingdom (UK) in March 2011.The aim of the visit was to find out how these services support the health and well being of pharmacists and doctors, including the services provided and how they are funded.

Pharmacy Businesses in Aboriginal Health Services

By Rollo Manning Pharmacy and PR Consultant to Aboriginal health organisations and communities.

The pharmacy ownership debate is hotting up and Aboriginal health services should not be too far from the action when it comes to discussing the benefits to minority groups. The latest salvo against pharmacist only ownership comes from Terry Barnes, a policy consultant who was the secretary for the National Competition Policy Review of pharmacy regulation 12 years ago.

Revive, Renew and Refresh – the Clinical Cycle is Starting

For all good ideas to get off the ground there is a need to establish a sound education base, a strong infrastructure and the right rules to allow the idea to grow and bloom.And underpinning all that is a required investment in human capital, also the realisation that “What can’t go on, won’t go on”. I am referring to the great idea that pharmacy should build on its once pre-eminent position in primary health, and underpinning that idea with a population of pharmacy practitioners specialising in lifestyle illness. Their capabilities to include the delivering of a quality service the general public would value and pay for, without subsidy. There is a need to revive, renew and refresh the concepts for that good idea.

Why universities should teach alternative medicine

Editor's Note: There is a major debate under way, as to whether universities should accredit complementary and alternate (CAM) practitioners and their treatments.The group called Friends of Science in Medicine which is mostly comprised of medical academics is seeking to have courses such as chiropractic, homeopathy etc removed from a university's curriculum.There are many and varied modalities comprising CAM, and they are all popular in varying degrees.In asking a medical doctor about his singular viewpoint he responded "Without a doubt, CAM practitioners who hold a degree simply devalue the medical degree I worked so long and hard to acquire".The opposite view from CAM practitioners is that they treat mostly rejects from the medical stream and apparently respond to patient needs more appropriately.

The Universities (and others) Respond to FSM

"First do no harm" is the first law of orthodox medicine. CAM practitioners embrace this law and are proud of the fact that their version of medicine causes minimal damage when compared to some of the practices of orthodox medicine. Drug damage compared with alternate medicine damage is like comparing "chalk with cheese". So what's all the fuss about? The Friends of Science in Medicine (FSM) have certainly attracted a lot of media attention with their campaign to eliminate university training (and degrees) to a wide segment of complementary and alternate medicine (CAM) sciences. CEO of FSM, Loretta Marron, said in a recent posting to the i2P site:

Food system ‘heading for crisis’

Editor's Note: We have always known that a poor diet affected health.Apart from the choice of food there is also evidence that processed foods destroy nutrients valuable to health, there are further problems in the way crops are grown (mineral deficiencies in soil) and the "factory farming" of animals and the way they have to be treated with substances such as antibiotics.Add water and air pollution and the assault on human (and animal) health is intense.Water pollution has as a primary cause pharmaceutical drugs inserting themselves into the environment through sewerage.Those of us trained in clinical nutrition have known that nutritional supplementation to balance the effects of a bad diet is required to sustain general health.Pharmacists seeking to direct their clinical efforts into developing nutritional support programs are likely to find patients willing to pay for this type of personalised attention.As an adjunct to managing lifestyle illnesses and provide another benefit of a lower carbon footprint-this type of activity should provide pharmacists with a suitable direction to engage their under-utilised talents.The following media release by the Public Health Association of Australia may prove to be the impetus required for a universal movement in a positive direction.

Reviewing the top medical iPhone apps … what’s the diagnosis?

Editor's Note: This article was first published in "The Conversation" and each component of the article was written by a different person. Their names appear under the title for each written component as well as professional and personal data at the end of the article.There is a a bewildering range of medical apps available for use with an iPhone.Given pharmacists may soon be increasing the depth and scope of their consultations, serious thought should be given to the selection and use of these apps (and others) as a means of adding content to your consultation and the creation of a patient network that may function as a social support system.Your thoughts are encouraged in the panels at the foot of the article.

Nutraceuticals - Going Global & Mainstream

Editor's Note: Food as medicine is a concept that has been around for a long time.Now the "big end" of town has decided that this market is too good not to be part of. It is also a market area, unlike drugs, that is only moderately regulated.On the surface it appears good news that nutritional therapies will be developed that will prove better primary or complementary treatments for lifestyle disorders.In practice, natural molecules will be distorted to gain the "edge" of obtaining a patent.However, it will be a better alternative than popping a drug every day for the rest of your life.Local supermarkets in Australia are already embracing this market, and a range of "health foods" is already established as a separate department.Pharmacy will need to engage this market and individualise it with specialised information.

Recent decades have witnessed much criss-crossing between the food and pharmaceutical industries. Nestle SA on January 1 2011 placed a very big bet on a nutraceutical future with the creation of a Nestlé Health Science business unit. Much of how the Switzerland-based multinational will "pioneer a new industry between food and pharma" will be pieced together by a trusted insider, Luis Cantarell, the inaugural president/CEO of Nestlé Health Science.

Catch the early wave in 2012 and secure your valuable CPD Credits at the Guild Pharmacy Academy – NSW Convention

After a very successful inaugural event in February 2011, this focussed Convention Weekend returns to the Novotel Manly Pacific. The event will run from Friday 24 to Sunday 26 February 2012 – register now and you can earn up to 24 CPD Credits in just 2 days.

Daily CPD Credits from Guild Accreditation Workshop

Does the PGA Really Represent its Members

This month we have selected a media story that appeared in Pharmacy News on the 3 November 2011, and it is story of the continuing saga of direct distribution by Pfizer.The bigger story underneath is - what is the Pharmacy Guild of Australia doing to represent its members in this ongoing dispute?i2P has covered the direct distribution saga since its inception here in Australia.The problem seems to be worsening rather than improving, so we have asked Mark Coleman to comment.His comments appear below the media item that follows.